Mindful therapies can mean working with a mindfulness-based therapist or employing mindfulness as self-therapy.

Vipassana Insight Meditation

Buddhism is all about suffering Mindfulness encapsulates the seventh of the Noble Eightfold Path of Buddhism. With Vipassana Insight Meditation, when suffering arises you become mindful and take an interest in it instead of attempting to avert it. You learn to be comfortable with suffering instead of shooting second, third, and fourth arrows.

It is possible to experience pain in a straightforward, uncomplicated way that avoids optional suffering by not attaching ourselves to the left brain hemisphere Narrator’s messages. The Narrator can be the major source of suffering. As difficult as mindfulness may be, the alternative is one of extreme pain, not the straightforward uncomplicated pain, but the agony of dealing with the same tortuous unresolvable messages droning on relentlessly inside our skulls, day after day.

Mindfulness takes willpower and a benefit of mindfulness is that it builds willpower in all areas of life. The brain area associated with willpower affected by mindful meditation is the prefrontal cortex, the executive, problem-solving area of the cortex just behind the forehead. Many problems in our lives can be helped to some degree by strengthening willpower or self-control. Poor self-control is associated with anger, violence, poor diet, and alcohol and drug abuse.

We can use willpower to attend to the quality of the mind without becoming blinded by the things we are concerned about. In a metaphoric sense, we step back and look at the mind. Is it anxious, in a hurried state, relaxed, open, closed? By stepping back and becoming an observer, we take on a wider sense of awareness and perspective. We shift to Open-Focus attention.

We need a balance of narrow immersed attention and diffuse Open Focus where we attend to both foreground and background. With a soft focus we attend not only to objects but the space around them, inside and outside our bodies. We shift from rigidly held narrow focus to lightly held diffuse focus and as needed, back to a narrow focus when we alertly respond. It is when we hold a narrow focus all of the time that stress builds without release. We need balanced, flexible attention shifting between narrow and diffuse focus for optimal mental health.

Vipassana Insight Meditation diffuses attention and awareness on thoughts, feelings, urges, emotions, and sensations without holding on and without judging and without entanglements. You can practice while cooking, washing dishes, cleaning the house, or driving a car. Breathe deeply and easily, allowing thoughts, feelings, urges, sensations, and emotions to be.

With Insight Meditation you diffusely allow into your awareness thoughts, feelings, urges, emotions, sensations, and desires, without entanglement. Just a detached awareness, then return to a focus on your breath, again and again.

Any feeling, thought, or emotion, negative, positive, even violent is okay. Allow it to be. Allow it to pass. Step back from dialogues, from deliberations and concerns over past and future events, from thoughts, feelings, and urges. Move from a narrow straight-jacket perception of self and the world to an open-mode perception with the potential for revaluing and growth.

Insight Meditation steps back from perceived problems rather than attempting to solve them head-on. It shifts from a focus on problems to a focus on thinking style. It involves a cognitive shift from what you are thinking of to how you are thinking, the process of your thinking.

The content of what people think can be virtually anything. But the thought process for some if not many of us, though, involves a pattern of worry and rumination. Insight Meditation focuses on the recurrent, recycling, ideation of worry and rumination. Insight meditation takes a step back to look at the process or pattern of thinking, rather than the cognitive content. Of importance is not the belief or thought, but the way you respond to the belief or thought, the pattern by which you process thoughts and beliefs.

Reminding yourself non judgmentally is the core of Insight Meditation. A virtually endless source of mp3s awaits at the nonprofit Insight Meditation Center.

You can download sessions on concentration, attention, relaxing, dying, even full-day retreats, then listen while preparing meals, working out, and doing tasks that do not require full focus. Sessions are recorded during actual sitting and walking practice sessions. Mp3s and some of the books on this site and even a six-week online course are available at no cost.

With only 45 bits of attention focus available to attend with, coming back to your breath without being judgmental is about all you can do. Once you latch onto a thought or feeling, you forget all about breathing. So you come back again, over and over.

“Me” Former Student Self-Cluster

Metacognitive Therapy

Metacognitive Therapy (MCT) is based on Insight Meditation, which is based on Buddhist Meditation. Unlike Cognitive Behavior Therapy (CBT), which focuses on thoughts, MCT, and Insight Meditation move beyond a focus on thoughts to a focus on patterns of thinking.

Metacognition

The first time I heard the term was when I came to Seattle in 1992 and took graduate educational psychology courses. Metacognition had become a buzzword. In its simplest definition, metacognition is about understanding your thinking process. The term metacognition was coined in 1979 by American developmental psychologist John Flavell. Flavell defined metacognition as knowledge about and control of cognition.

Metacognition had little or nothing to do with psychotherapy until 1994 when Adrian Wells of the University of Manchester, UK described Metacognitive Therapy (MCT) in a series of research papers.

MCT, a form of Insight Meditation, steps back from perceived problems rather than attempting to solve them head-on. It shifts from a focus on problems to a focus on thinking style. It involves a cognitive shift from what you are thinking to how you think.

The content of what people think can be virtually anything. The thought process, though, involves a constant pattern of worry and rumination. MCT focuses on this recurrent, recycling, ideation of worry and rumination. MCT involves the process or pattern of thinking, rather than cognitive content. Psychological disorder occurs principally as a result of extended thinking which prolongs emotion. Of importance is not the belief or thought, but the way you respond to the belief or thought, the pattern by which you process thoughts and beliefs.

Cognitive-Attentional Syndrome (CAS)

This maze of worrisome behaviors keeps emotional fires burning by increasing the sense of danger, creating a vicious cycle of escalating fear and anxiety. Worry and rumination disrupt a built-in recovery process. Instead of top-down control via the frontal cortex executive brain center, a bottom-up surge from the deep, emotional limbic brain takes control.

CAS is an attentional strategy of threat monitoring. Attention gets fixed on threatening stimuli. A person with OCD monitors forbidden thoughts, feelings, and behaviors. A paranoid monitors people’s suspicious behaviors. The hypochondriac monitors the body for signs of disease. Threat monitoring increases access to negative information and maintains a sense of threat.

Patterns Over Problems

A cognitive therapist works with perceived problems. A metacognitive therapist works with patterns of worry rumination, fixation, and other unhealthy patterns of thinking. that maintain emotional disturbance.

MCT deals with the way you think, the inflexible, recurrent styles of thinking in response to negative thoughts, feelings, and beliefs. You cannot think or ruminate your way out of chronic mental problems. Mental problems are the inflexible, recurrent, ruminating, perseverating thinking style.

Instead of questioning and reality-testing thoughts, feelings, and beliefs, MCT focuses on how you respond to thoughts, feelings, and beliefs. Exactly as in Vipassana/Insight Meditation, MCT steps back, examining thought processes and patterns. Most people think the thoughts about themselves and the world are reality. But thoughts and beliefs are filters for viewing oneself and the world, each of us with our unique filters.

Attention Training Therapy (ATT)

ATT is an MCT method of working on reducing Cognitive Attentional Syndrome (CAS) patterns of thinking and behaving. These sound exercises parallel the visual Open-Focus ones. Wells developed ATT to reduce perseverative thinking, increase attentional flexibility, reduce self-focused attention, and respond more appropriately to events in the external world. On his mp3, you listen to sounds individually and in combinations while focusing your gaze on a fixed mark ahead. You can find instructions in his book, “Metacognitive Therapy for Anxiety and Depression.” I would add OCD to the title.

You first monitor or assess the extent of self-focus, which is considerable when you are self-obsessed. Wells devised a simple scale from -3 to +3 where -3 is entirely self-focused on thoughts, feelings, and behavior, and +3 is entirely focused on task or environment. Task includes something as basic as having a conversation and focusing on the other person rather than self. The environment means everything going on outside you.

Wells developed sound-based exercises similar to Open-Focus exercises. His recorded ATT exercises run for a total of eleven minutes and thirty seconds. You focus first on the voice of the narrator, ignoring all distracting sounds.

You focus on a ticking clock, church bells, traffic sounds, birds singing, running water, and insects chirping. You focus on sounds outside of the recorded sounds, sounds from the space about you. You focus on the spaces to your left and right, then back to a focus on the sounds on the recording, shifting focus among the different sounds and areas of space, as guided by the narrator. You focus on the sounds away from the recording, on the spaces around you, shifting back to the sounds of the recording, away from the recording, and back. Finally, you focus on sounds in as broad a scope as you can.

It is difficult to sort out and isolate some of the sounds on the recording, but listening to these sound exercises is practice for ATT Open-Focus in the real world. Sounds are a distraction in the workplace. You can work with these sounds as you would the recorded exercises, moving and shifting from sound to sound, background to foreground, space to space, selecting your focus, moving on to another focus. You can listen to all sounds together, seeing how many you can hear and focus on, sounds to the space on your left, right, background, foreground, above, below.

When I was teaching, one or two students would try to distract me with tapping and crinkling paper sounds. If I were not heavily drugged on some form of diazepam, I could not focus on what I was saying. The classroom is perfect on-the-job training for these exercises. The exercises might begin by focusing on the tapping sound and expanding from there. With practice, I would have been able to function in the classroom with less, maybe even without diazepam. But I missed that chance and the opportunity to share the training with my students. But I have successfully used the technique now outside of the classroom.

MCT shines a light on CAS. You recognize patterns of thinking and coping that lock you into states of emotional distress. You work on replacing these patterns with more productive ways of focusing.

Most psychotherapy is content-based, focusing on what you think and believe are your problems. This drives an obsessive thinker deep into content-based-ruminations, dwelling on unresolvable problems. It can sometimes be more productive to step back in a flexible, mindful way and attend to patterns of thoughts and feelings.

Self-help books that help:

Total Self-Renewal through Attention Therapies and Open Focus

The Open-Focus Brain: Harnessing the Power of Attention to Heal Mind and Body